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Vol. 21. Num. 2. 2012. Pages 181-193

Multisystemic Therapy: Clinical Foundations and Research Outcomes

[Terapia Multisistémica: Fundamentos Clínicos y Resultados de Investigación]

Henggeler,Scott W.

Medical University of South Carolina, USA

Abstract

Multisystemic therapy (MST) is an intensive family and community-based treatment for adolescents presenting serious antisocial behavior and their families. Using a home-based model of service delivery to overcome barriers to service access and a strong quality assurance system to promote treatment fidelity, MST therapists address known risk factors (i.e., at individual, family, peer, school, and community levels) strategically and comprehensively. The family is viewed as central to achieving favorable outcomes, and mediation research supports the emphasis of MST on promoting family functioning as the key mechanism of clinical change. Importantly, 22 MST outcome studies have been published, many of which are independent randomized clinical trials, and the vast majority, including those conducted in Europe, support the capacity of MST to reduce youth antisocial behavior and out-of-home placements. Such outcomes, combined with the advocacy of many juvenile justice stakeholders, have led to the transport of MST programs to more than 500 sites, including 10 nations in Europe.

Resumen

La terapia multisistémica (TMS) es un tratamiento intensivo en el ámbito familiar y comunitario dirigido a adolescentes con comportamientos antisociales graves y a sus familias. Mediante un modelo de atención en el hogar para romper las barreras de acceso al servicio y un sistema de garantías sólido y de calidad para promover la fidelidad al tratamiento, los terapeutas de TMS abordan factores de riesgo conocidos (es decir, a nivel individual, familiar, de iguales y de la comunidad) de forma estratégica y exhaustiva. Se considera a la familia como un elemento fundamental para la obtención de resultados favorables y la investigación sobre variables mediadoras, apoya el énfasis que el TMS pone en promover el funcionamiento familiar como mecanismo clave para el cambio clínico. Es importante señalar que la mayor parte de los 22 estudios de resultados publicados, muchos de ellos ensayos clínicos aleatorios independientes y algunos realizados en Europa, confirman la capacidad de la TMS para reducir la conducta juvenil antisocial y el número de reubicación de menores fuera del hogar familiar. Dichos resultados, junto al apoyo de muchas de las partes implicadas en los procesos judiciales con menores, han propiciado la implementación de programas de TMS en más de 500 lugares, incluyendo 10 naciones europeas.

Keywords

behavior problems
intervention
multisystemic-therapy
outcomes
randomized clinical-trial
serious juvenile offenders

Palabras clave

ensayo clínico aleatorio
intervención
problemas de conducta
resultados
terapia multisistémica
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